Gillian Gans & Emily Madera

Case Report
Bipolar Disorder

Summary Symptoms

Bipolar disorder is known as a Manic symptoms may include high energy,

manic-depressive illness, Its brain disorder
that causes unusual shifts in mood, energy,
activity levels, and the ability to carry out
day-to-day tasks.There are four basic types
of bipolar disorder; all of them involve
changes in mood, energy, and activity levels.
These moods range from periods of
extremely up, elevated, and energized
behavior (known as manic episodes) to very
sad, down, or hopeless periods (known as
depressive episodes). Less severe manic
periods are known as hypomanic episodes.
There are also different ways to scale the
intensity in bipolar disorder. Different
actions or behaviors categorize your level.
Bipolar I disorder:Having at least one manic
episode that can be followed by hypomanic
or major depressive episodes. Mania may
trigger a break from reality.
Bipolar II disorder. Having at least one
major depressive episode and one or more
hypomanic episode, but never having a
manic episode.
Cyclothymic disorder. Having at least two
years or one year in children and teenagers
of many periods of hypomania symptoms
and periods of depressive symptoms.
loss of touch with reality, and reduced need
for sleep.
Depressive episodes include symptoms such
as low energy, low motivation, and loss of
interest in daily activities. Mood episodes last
days to months at a time and can also be
associated with suicidal thoughts.
Mood: mood swings, sadness, elevated
mood, anger, anxiety, apathy, apprehension,
euphoria, general discontent, guilt,
hopelessness, loss of interest, or loss of
interest or pleasure in activities
Behavioral: irritability, disorganized behavior,
aggression, agitation, crying, excess desire for
sex, hyperactivity, impulsivity, restlessness, or
self-harm
Cognitive: unwanted thoughts, delusion, lack
of concentration, racing thoughts, or
slowness in activity
Psychological: depression, manic episode,
agitated depression, or paranoia
Sleep: difficulty falling asleep or excess
sleepiness
Weight: weight gain or weight loss
Also common: risky behavior, false belief of
superiority, fatigue, or rapid and frenzied
speaking

History
The terms manicdepressive illness and bipolar disorder are recent, and date back to the 1950s and 1980s. The
term bipolar disorder (or bipolar affective disorder) is thought to be less stigmatizing than the older term
manicdepressive illness, and so the newer term has largely changed the image of the disorder. However, some
psychiatrists and some people with bipolar disorder still prefer the term manicdepressive illness because they feel
that it reflects how they feel. The relationship between the two most common feelings in bipolar disorder are
melancholy and mania. They can be traced back to the Ancient Greeks, and particularly to Aretaeus of Cappadocia,
who was a physician and philosopher in the time of Nero of Vespasian (first century AD). Aretaeus described a group
of patients that laugh, play, dance night and day, and sometimes go openly to the market crowned, as if victors in
some contest of skill only to be torpid, dull, and sorrowful at other times. Although he suggested that both patterns
of behavior resulted from one and the same disorder, this idea did not gain currency until the modern era.
Affected Ages Frequency

The median age of onset for bipolar disorder is 25
years, although the illness can start in early childhood
or as late as the 40's and 50's. Bipolar disorder is more
likely to affect the children of parents who have the
disorder. When one parent has bipolar disorder, the
risk to each child is l5% to 30%. When both parents
have bipolar disorder, the risk increases to 50 to 75%.
Around 20% of adolescents with major depression
develop bipolar disorder within five years of the onset
of depression. One-third of the 3.4 million children and
adolescents with depression in the United States may
actually be experiencing the early onset of bipolar
disorder. When manic, children and adolescents are
more likely to be irritable and prone to destructive
outbursts than to be elated or euphoric. When
depressed, there may be many physical complaints
such as headaches, and stomachaches or tiredness;
poor performance in school, irritability, social
isolation, and extreme sensitivity to rejection or
failure.
Bipolar disorder affects approximately there are 5.7
million adult Americans, or about 2.6% of the U.S.
population age 18 and older every year.An equal
number of men and women develop bipolar illness
and it is found in all ages, races, ethnic groups and
social classes. More than two-thirds of people with
bipolar disorder have at least one close relative with
the illness or with unipolar major depression,
indicating that the disease has a heritable
component. Although bipolar disorder is equally
common in women and men, research indicates that
approximately three times as many women as men
experience rapid cycling. Females with Bipolar
Disorder I tend to have more rapid cycling and mixed
feature episodes than males do. Females also tend to
have co-occurring eating disorders. Females with
bipolar I and bipolar II are more likely than males to
experience depressive episodes, have a higher risk of
alcohol use disorder.

Research

The National Comorbidity Study reported a lifetime prevalence of nearly 4% for bipolar disorder. Bipolar disorder is
more common in women than men, with a ratio of approximately 3:2. The median age of onset for bipolar disorder is
25 years, with men having an earlier age of onset than women. In an insured population, 7.5% of all with behavioral
health care coverage filed a claim, of which 3.0% had bipolar disorder. People with bipolar disorder incurred $568 in
annual out-of-pocket expenses more than double the expenses incurred by all claimants. Annual insurance payments
were greater for medical services for persons with bipolar disorder than for patients with other behavioral healthcare
diagnoses. The inpatient hospitalization rate of bipolar patients (39.1%) was greater than the 4.5% characterizing all
other patients with behavioral health care diagnoses.

Changes in Treatment

There are success rates of 70 to 85% with lithium for the acute phase treatment of mania, but throughout the
years lithium response rates have dropped to 40 to 50%. Participation in a DBSA (Depression and Bipolar Support
Alliance) patient-to-patient support group improved treatment compliance by almost 86% and reduced in-patient
hospitalization. Consumers with bipolar disorder face up to ten years of coping with symptoms before getting an
accurate diagnosis, with only one in four receiving an accurate diagnosis in less than three years. A gender bias
exists in the diagnosis of bipolar disorder: women are far more likely to be misdiagnosed with depression and men
are far more likely to be misdiagnosed with schizophrenia. Nearly 9 out of 10 consumers with bipolar disorder are
satisfied with their current medication. Also consumers who have satisfaction with their treatment and doctors
have a more positive outlook about their illness and their ability to cope with it.
Statistics

Bipolar disorder is the sixth leading cause of disability Bipolar disorder results in 9.2 years reduction in
in the world. (World Health Organization) expected life span, and as many as one in five
patients with bipolar disorder completes suicide.
(National Institute of Mental Health)

The National Institute of Mental Health (NIMH)
conservatively estimates the total costs associated with
serious mental illness, those disorders that are severely
debilitating and affect about 6 percent of the adult
population, exceed $300 billion per year.
Bipolar disorder has been deemed the most expensive
behavioral health care diagnosis costing more than twice
as much as depression per affected individual. Total
costs largely arise from indirect costs and are
attributable to lost productivity, in turn arising from
absenteeism and presenteeism.

Citations

http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/home/ovc-20307967
https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
https://www.psychologytoday.com/blog/hide-and-seek/201206/short-history-bipolar-disorder
http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_bipolar_disorder
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/bipolar-disorder/
http://www.amhc.org/4-bipolar-disorder/article/11200-statistics-and-patterns-in-bipolar-disorder
https://www.nimh.nih.gov/health/statistics/index.shtml
http://www.statisticbrain.com/bipolar-disorder-statistics/
http://www.euro.who.int/en/health-topics/noncommunicable-diseases/mental-health/data-and-statistics
https://www.cdc.gov/mentalhealth/basics/burden.htm